HSCT-associated complications of the skin, hair, and nails

Abstract

HSCT-associated skin, hair, and nail changes are very common. Skin complications range from breakdown of the skin integrity due to chemotherapy or total body irradiation (TBI) during the peri-HSCT period to significant changes (sclerodermatous and lichenoid changes) due to chronic graft-versus-host disease (GvHD) that can be lifelong and lifethreatening. The most common causes of skin complications are drug allergy, engraftment syndrome, chemotherapy-induced, radiation-induced, GvHD, infection, and contact dermatitis. Nail changes can occur in HSCT recipients, and they are most often caused by chemotherapy, radiation, and GvHD. Hair changes associated with HSCT include partial or total alopecia that is usually temporary but can be permanent and most often due to chemotherapy, radiation, or chronic GvHD. Change in color or texture can also occur in HSCT recipients. This chapter addresses skin, nail, and hair complications found in HSCT recipients with the exception of GvHDrelated because this topic is detailed elsewhere in Chapters 17 (Acute Graft-Versus-Host Disease: Diagnosis, Prophylaxis, and Treatment) and 19 (Chronic Graft-Versus-Host Disease).